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Bile Esophagitis

Bile Esophagitis Abstract ESOPHAGITIS following subtotal or total gastrectomy, as in patients who have little or no acid in their gastric juice, is a well-established clinical entity.1,2 The reflux of alkaline secretions originating in the pancreas and liver have been incriminated as the principal etiological agents. Palmer3 has suggested, however, that in some people a primary subepithelial disease of the esophagus exists. Others have implied infectious, vascular aberrations, vitamin deficiencies, and inherent susceptibility of the lower esophagus to the trauma of ingested food as causative factors leading to the pathological and clinical pictures of esophagitis.2 In contrast to the esophagitis of acid or peptic reflux, investigative experiments have been minimal and the role of various possible agents, one of which is bile, very controversial. Cross and Wangensteen4 produced esophagitis in dogs with bile, pancreatic juices, and a mixture of the two. However, Redo5,6 was unable to produce such References 1. Fenwal Laboratories, Morton Grove, Ill. 2. Helsingen, N., Jr.: Esophagitis Following Total Gastrectomy , Acta Chir Scand 118:190-201, 1959-1960. 3. Helsingen, N., Jr.: Esophagitis Following Total Gastrectomy: A Clinical and Experimental Study , Acta Chir Scand , (suppl 273) , pp 1-21, 1961. 4. Palmer, E.D.: Subacute Erosive "Peptic" Esophagitis Associated With Achlorhydria , New Eng J Med 262:927-929, 1960.Crossref 5. Cross, F.S., and Wangensteen, O.H.: Role of Bile and Pancreatic Juice in the Production of Esophageal Erosions and Anemia , Proc Soc Exp Biol Med 77:862-866, 1961.Crossref 6. Redo, S.F.; Barnes, W.A.; and Sierra, A.O.: Perfusion of the Canine Esophagus With Secretions of the Upper Gastrointestinal Tract , Ann Surg 149:556-564, 1959.Crossref 7. Redo, S.F., and Barnes, W.A.: Effects of the Secretions of the Stomach, Duodenum, Jejunum, and Colon in the Esophagus of the Dog , Surg Gynec Obstet 106:337-342, 1958. 8. Lambert, R.: Relative Importance of Biliary and Pancreatic Secretions in the Genesis of Esophagitis in Rats , Amer J Dig Dis 7:1026-1033, 1962.Crossref 9. Sobotka, H.: Physiological Chemistry of the Bile , Baltimore: Williams and Wilkins Co., 1937. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1965.01320180097021
Publisher site
See Article on Publisher Site

Abstract

Abstract ESOPHAGITIS following subtotal or total gastrectomy, as in patients who have little or no acid in their gastric juice, is a well-established clinical entity.1,2 The reflux of alkaline secretions originating in the pancreas and liver have been incriminated as the principal etiological agents. Palmer3 has suggested, however, that in some people a primary subepithelial disease of the esophagus exists. Others have implied infectious, vascular aberrations, vitamin deficiencies, and inherent susceptibility of the lower esophagus to the trauma of ingested food as causative factors leading to the pathological and clinical pictures of esophagitis.2 In contrast to the esophagitis of acid or peptic reflux, investigative experiments have been minimal and the role of various possible agents, one of which is bile, very controversial. Cross and Wangensteen4 produced esophagitis in dogs with bile, pancreatic juices, and a mixture of the two. However, Redo5,6 was unable to produce such References 1. Fenwal Laboratories, Morton Grove, Ill. 2. Helsingen, N., Jr.: Esophagitis Following Total Gastrectomy , Acta Chir Scand 118:190-201, 1959-1960. 3. Helsingen, N., Jr.: Esophagitis Following Total Gastrectomy: A Clinical and Experimental Study , Acta Chir Scand , (suppl 273) , pp 1-21, 1961. 4. Palmer, E.D.: Subacute Erosive "Peptic" Esophagitis Associated With Achlorhydria , New Eng J Med 262:927-929, 1960.Crossref 5. Cross, F.S., and Wangensteen, O.H.: Role of Bile and Pancreatic Juice in the Production of Esophageal Erosions and Anemia , Proc Soc Exp Biol Med 77:862-866, 1961.Crossref 6. Redo, S.F.; Barnes, W.A.; and Sierra, A.O.: Perfusion of the Canine Esophagus With Secretions of the Upper Gastrointestinal Tract , Ann Surg 149:556-564, 1959.Crossref 7. Redo, S.F., and Barnes, W.A.: Effects of the Secretions of the Stomach, Duodenum, Jejunum, and Colon in the Esophagus of the Dog , Surg Gynec Obstet 106:337-342, 1958. 8. Lambert, R.: Relative Importance of Biliary and Pancreatic Secretions in the Genesis of Esophagitis in Rats , Amer J Dig Dis 7:1026-1033, 1962.Crossref 9. Sobotka, H.: Physiological Chemistry of the Bile , Baltimore: Williams and Wilkins Co., 1937.

Journal

Archives of SurgeryAmerican Medical Association

Published: Dec 1, 1965

References